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Claims Resolution Specialist at Opelousas General Health System
Opelousas, Louisiana, United States - Full Time
Skills Needed
Claims Resolution, Analytical Skills, Business Writing, Eob Understanding, Managed Care Contracts, Icd 10 Coding, Hcpcs Coding, Cpt Coding, Medical Terminology, Microsoft Office, Emr Systems, Contract Interpretation, Critical Thinking, Problem Solving, Attention To Detail, Professional Communication
Specialization
Candidates should have an associate's degree or equivalent experience, along with 3-5 years in a healthcare revenue cycle environment. Familiarity with billing, collections, coding, and insurance appeals is essential, with hospital-based experience preferred.
Experience Required
Minimum 2 year(s)
MECANICIEN CONFIRME (H / F) at Groupement Mousquetaires
Mellac, Brittany, France - Full Time
Skills Needed
Team Spirit, Customer Service, Motivation, Dynamism, Diagnostic Skills, Mechanical Repair, Electrical Repair, Maintenance, Climatisation, Organizational Skills, Attention To Detail, Safety Compliance, Quality Control, Communication Skills, Problem Solving
Specialization
Candidates should hold a relevant qualification such as CAP, Bac Pro, or equivalent in automotive maintenance. A valid driver's license (Permis B) is also required.
Experience Required
Minimum 2 year(s)
Commis de Cuisine - Restaurant Christopher Coutanceau (17) at Sige Relais Chateaux
La Rochelle, Nouvelle-Aquitaine, France - Full Time
Skills Needed
Culinary Skills, Teamwork, Food Preparation, Gastronomy, Sustainability
Specialization
A professional culinary training is required along with experience in a Michelin-starred establishment. A passion for gastronomy is essential.
Experience Required
Minimum 2 year(s)
Research Analyst at NielsenIQ
Mumbai, maharashtra, India - Full Time
Skills Needed
Analytical Skills, Organizational Skills, Oral Communication Skills, Written Communication Skills, Customer Service Skills, Multi Tasking Skills
Specialization
A Master's Degree is required for this position, along with knowledge of Microsoft Word, Excel, and PowerPoint. Strong analytical and communication skills are essential.
Senior Research Scientist at NielsenIQ
Chennai, tamil nadu, India - Full Time
Skills Needed
Generative Ai, Large Language Models, Fine Tuning, Prompt Engineering, Semantic Search, Vector Databases, Hallucination Detection, Summarization, Model Evaluation, Python, Pytorch, Tensorflow, Scikit Learn, Machine Learning Fundamentals, Experimentation, Feature Engineering
Specialization
Candidates should have over 10 years of experience and a strong foundation in machine learning and data science. They must possess expertise in Generative AI and applied machine learning skills, along with strong coding abilities in Python.
Experience Required
Minimum 10 year(s)
Lead Research Scientist at NielsenIQ
Chennai, tamil nadu, India - Full Time
Skills Needed
Generative Ai, Applied Machine Learning, Python, Ml Libraries, Technical Leadership, Stakeholder Engagement, Model Development, Innovation Leadership, Feature Engineering, Hypothesis Driven Problem Solving, Deployment Pipelines, Scalability, Collaboration, Communication, Quality Assurance, Mentoring
Specialization
Candidates should have over 15 years of experience in Generative AI and applied machine learning, with strong coding abilities and a solid foundation in ML principles. They must possess visionary leadership skills and the ability to communicate complex concepts effectively.
Experience Required
Minimum 10 year(s)
Business Development Leader - Uganda at Visa
Kampala, Arua, Uganda - Full Time
Skills Needed
Business Development, Relationship Management, Strategic Planning, Sales Leadership, Risk Management, Compliance, Marketing, Innovation, Financial Acumen, Cross Functional Collaboration, Communication, Project Management, Client Solutions, Entrepreneurial Mindset, Cultural Navigation, Analytical Skills
Specialization
Candidates should have extensive experience in the payments and digital commerce industry, with strong commercial acumen and sales leadership skills. A proven ability to manage P/L and drive innovation in a fast-paced environment is essential.
Experience Required
Minimum 10 year(s)
Housekeeping Coordinator at Accor
Miami Beach, Florida, United States - Full Time
Skills Needed
Housekeeping, Communication, Organization, Attention To Detail, Multitasking, Teamwork, Pms Systems, Guest Service, Scheduling, Reporting, Inventory Management, Training, Problem Solving, Time Management, Administrative Skills, Service Standards
Specialization
Candidates should have 3-5 years of experience in housekeeping or hotel operations, along with strong administrative and communication skills. Proficiency in hotel PMS/Housekeeping systems and the ability to multitask in a fast-paced environment are essential.
Experience Required
Minimum 2 year(s)
Développeur .Net / Devsecops at Tilencia
Paris, Ile-de-France, France - Full Time
Skills Needed
Devops, Cybersecurity, Ci/Cd, Cloud Native, .Net Core, Apis, Infrastructure As Code, Automation, Powershell, Bash, Azure Cli, Python, Agile, User Centric, Documentation, Collaboration
Specialization
Candidates should have experience in designing and developing CI/CD solutions, as well as knowledge of cybersecurity and cloud architectures. Autonomy, rigor, and strong writing skills are also essential.
Experience Required
Minimum 2 year(s)
Data Analytics Engineer at easyJet
, , - Full Time
Skills Needed
Python, Sql, Troubleshooting, Tableau, Thoughtspot, Aws, Gcp, Databricks, Redshift, Bigquery, Snowflake, Apis, Databases, Collaboration, Innovation, Results Focused
Specialization
Candidates should have strong Python and SQL skills, along with experience in troubleshooting data pipeline issues. Familiarity with analytics platforms and cloud services is also required.
Experience Required
Minimum 2 year(s)
Data Analytics Engineer at easyJet
, , - Full Time
Skills Needed
Python, Sql, Troubleshooting, Tableau, Thoughtspot, Aws, Gcp, Databricks, Redshift, Bigquery, Snowflake, Apis, Databases, Collaboration, Innovation, Results Orientation
Specialization
Candidates should have strong Python and SQL skills, along with experience in troubleshooting data pipeline issues. Familiarity with analytics platforms and cloud services is also required.
Experience Required
Minimum 2 year(s)
Reservations Manager - Raffles the Red Sea at Accor
Umluj, Tabuk, Saudi Arabia - Full Time
Skills Needed
Creativity, Stress Management, Self Development, Listening Skills, Oral Skills, Delegation, Organization, Deadline Management, Leadership, Training, Instruction, Reservation Management, Customer Service, Problem Solving, Communication, Report Generation
Specialization
Candidates should have a degree or diploma in Training and Development or Hotel Management, along with a minimum of 3 years of experience in a hotel or resort setting. Experience in luxury hotels and understanding of local culture is preferred.
Experience Required
Minimum 2 year(s)
Cafe Barista at Accor
Miami Beach, Florida, United States - Full Time
Skills Needed
Coffee Preparation, Guest Service, Team Collaboration, Inventory Management, Health And Safety Standards, Communication Skills, Multitasking, Espresso Machine Operation, Latte Art, Food Hygiene, Attention To Detail, Positive Attitude, Customer Service, Continuous Learning, Problem Solving, Organizational Skills
Specialization
Candidates should have a high school diploma and proven experience in coffee preparation. Strong communication skills and the ability to multitask in a fast-paced environment are essential.
Equipier Commercial CDD F/H at METRO/MAKRO
Vannes, Brittany, France - Full Time
Skills Needed
Teamwork, Customer Relationship, Operational Skills, Product Knowledge, Sales Skills, Attention To Detail
Specialization
The ideal candidate should demonstrate rigor and a desire to work in a team environment. Strong interpersonal skills and a proactive attitude are essential.
Senior Scientist at Eurofins
Portage, Michigan, United States - Full Time
Skills Needed
Analytical Procedures, Attention To Detail, Communication, Data Processing, Gmp, Glp, Instrumentation, Laboratory Equipment Maintenance, Reagent Preparation, Sample Preparation, Teamwork, Validation Projects
Specialization
Candidates should have a Bachelor's degree in a related field and at least three years of related experience. Excellent communication skills and the ability to work independently or as part of a team are essential.
Experience Required
Minimum 2 year(s)
Consultant(e) Transport, Manufacturing & Retail - Bureau de Lyon at Sia Partners - United Kingdom
Lyon, Auvergne-Rhône-Alpes, France - Full Time
Skills Needed
Teamwork, Analytical Skills, Project Management, Change Management, Marketing, Distribution Strategy, Supply Chain Strategy, Data Science, Regulatory Compliance, Risk Management, Process Redesign, Client Engagement, Training Development, Business Development, Innovation, Entrepreneurship
Specialization
Candidates should have a degree from a prestigious engineering or business school and ideally possess experience in consulting or relevant sectors. Strong teamwork, analytical skills, and proficiency in French and English are essential.
Experience Required
Minimum 2 year(s)
Microbiolgy Analyst at COMBE INCORPORATED.
Rantoul, Illinois, United States - Full Time
Skills Needed
Basic Math Skills, Good Organizational Skills, Computer Data Entry, Ability To Follow Written Directions
Specialization
A high school diploma or equivalent is required, with some microbiology experience preferred. The position also requires good vision, legible handwriting, and the ability to perform physical tasks.
Ingénieur thermicien H/F at Socotec
Saint-Ouen-sur-Seine, Ile-de-France, France - Full Time
Skills Needed
Thermal Engineering, Energy Audits, Thermal Simulation, Technical Expertise, Building Regulations, Thermography, Cvc Knowledge
Specialization
Candidates should have a degree in engineering or equivalent and demonstrate analytical skills, curiosity, autonomy, and writing abilities. Required knowledge includes building thermal performance and proficiency in thermal and energy study software.
Technicien en mesure de la performance des bâtiments H/F at Socotec
Strasbourg, Grand Est, France - Full Time
Skills Needed
Acoustic Measurement, Thermal Performance Measurement, Air Tightness Testing, Regulatory Compliance, Client Advisory, Project Assistance, Technical Training, Organizational Skills, Customer Service, Commercial Awareness
Specialization
Candidates should have a technical background in building with a Bac +2 / +4 education and ideally three years of experience in the field. Qualifications in air tightness measurement and energy performance certification are preferred.
Experience Required
Minimum 2 year(s)
Delivery Driver - Hiring All Shifts - 1721 Spring Green at Domino's Pizza LLC
Katy, Texas, United States - Full Time
Skills Needed
Customer Service, Food Safety, Store Operations, Technology Operation, Troubleshooting
Specialization
Candidates must have a valid driver's license and access to an insured vehicle for deliveries. They should also be at least 18 years old with one year of driving history.
Claims Resolution Specialist at Opelousas General Health System
Opelousas, Louisiana, United States -
Full Time

Start Date

Immediate

Expiry Date

10 Mar, 26

Salary

0.0

Posted On

10 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Claims Resolution, Analytical Skills, Business Writing, EOB Understanding, Managed Care Contracts, ICD-10 Coding, HCPCS Coding, CPT Coding, Medical Terminology, Microsoft Office, EMR Systems, Contract Interpretation, Critical Thinking, Problem Solving, Attention to Detail, Professional Communication

Industry

Hospitals and Health Care

Description
CLAIMS RESOLUTION SPECIALIST Job Summary: The Claims Resolution Specialist plays a key role in ensuring accurate and timely reimbursement by validating denial reasons, researching payer policies, and generating effective appeals. This position requires a critical thinker with strong analytical skills, adept at using tools such as NCCI edits, payer portals, and contract interpretation to overturn denials. The ideal candidate demonstrates exceptional attention to detail, professional communication, and mastery of grammar and business writing. ---------------------------------------- ESSENTIAL DUTIES AND RESPONSIBILITIES * Review and validate denial reasons against Explanation of Benefits (EOB) and ensure coding accuracy in collaboration with the HIM department. * Coordinate with Case Management for clinical consultations or account referrals when necessary. * Research payer guidelines and contract terms to develop compelling appeals, including online reconsiderations. * Submit appeals in compliance with payer-specific requirements and escalate unresolved cases for further action. * Investigate and resolve adjudication issues, including contract interpretation and overpayment referrals. * Utilize NCCI edits and other industry tools to identify and correct claim discrepancies. * Document all research, actions, and outcomes accurately in the EMR system and route accounts appropriately. * Monitor denial and payment variance trends; escalate significant patterns to management for payer intervention. * Participate in payer projects and special initiatives as directed. ---------------------------------------- KNOWLEDGE, SKILLS, AND ABILITIES * Strong critical thinking and problem-solving skills with the ability to analyze complex claim issues. * Advanced proficiency in business writing, grammar, and professional correspondence. * Understanding of EOBs, managed care contracts, and federal/state requirements. * Working knowledge of UB-04 billing requirements, ICD-10, HCPCS/CPT coding, and medical terminology. * Proficiency in Microsoft Office (Word, Excel) and familiarity with EMR systems. * Ability to interpret contract language and apply it effectively in appeals. ---------------------------------------- EDUCATION AND EXPERIENCE * Associate’s degree or equivalent experience preferred. * 3–5 years in a healthcare revenue cycle environment with experience in billing, collections, coding, and insurance appeals.  * Hospital-based experience is an advantage. * Cerner experience preferred or relevant aptitude within EMR-based billing applications. ---------------------------------------- PHYSICAL DEMANDS AND WORK ENVIRONMENT * Ability to sit and work at a computer for extended periods. * Work in a collaborative office setting with multiple workstations in close proximity.
Responsibilities
The Claims Resolution Specialist is responsible for validating denial reasons, researching payer policies, and generating effective appeals to ensure accurate reimbursement. This includes coordinating with various departments, submitting appeals, and documenting all actions in the EMR system.
Claims Resolution Specialist at Opelousas General Health System
Opelousas, Louisiana, United States - Full Time
Skills Needed
Claims Resolution, Analytical Skills, Business Writing, Eob Understanding, Managed Care Contracts, Icd 10 Coding, Hcpcs Coding, Cpt Coding, Medical Terminology, Microsoft Office, Emr Systems, Contract Interpretation, Critical Thinking, Problem Solving, Attention To Detail, Professional Communication
Specialization
Candidates should have an associate's degree or equivalent experience, along with 3-5 years in a healthcare revenue cycle environment. Familiarity with billing, collections, coding, and insurance appeals is essential, with hospital-based experience preferred.
Experience Required
Minimum 2 year(s)
MECANICIEN CONFIRME (H / F) at Groupement Mousquetaires
Mellac, Brittany, France - Full Time
Skills Needed
Team Spirit, Customer Service, Motivation, Dynamism, Diagnostic Skills, Mechanical Repair, Electrical Repair, Maintenance, Climatisation, Organizational Skills, Attention To Detail, Safety Compliance, Quality Control, Communication Skills, Problem Solving
Specialization
Candidates should hold a relevant qualification such as CAP, Bac Pro, or equivalent in automotive maintenance. A valid driver's license (Permis B) is also required.
Experience Required
Minimum 2 year(s)
Commis de Cuisine - Restaurant Christopher Coutanceau (17) at Sige Relais Chateaux
La Rochelle, Nouvelle-Aquitaine, France - Full Time
Skills Needed
Culinary Skills, Teamwork, Food Preparation, Gastronomy, Sustainability
Specialization
A professional culinary training is required along with experience in a Michelin-starred establishment. A passion for gastronomy is essential.
Experience Required
Minimum 2 year(s)
Research Analyst at NielsenIQ
Mumbai, maharashtra, India - Full Time
Skills Needed
Analytical Skills, Organizational Skills, Oral Communication Skills, Written Communication Skills, Customer Service Skills, Multi Tasking Skills
Specialization
A Master's Degree is required for this position, along with knowledge of Microsoft Word, Excel, and PowerPoint. Strong analytical and communication skills are essential.
Senior Research Scientist at NielsenIQ
Chennai, tamil nadu, India - Full Time
Skills Needed
Generative Ai, Large Language Models, Fine Tuning, Prompt Engineering, Semantic Search, Vector Databases, Hallucination Detection, Summarization, Model Evaluation, Python, Pytorch, Tensorflow, Scikit Learn, Machine Learning Fundamentals, Experimentation, Feature Engineering
Specialization
Candidates should have over 10 years of experience and a strong foundation in machine learning and data science. They must possess expertise in Generative AI and applied machine learning skills, along with strong coding abilities in Python.
Experience Required
Minimum 10 year(s)
Lead Research Scientist at NielsenIQ
Chennai, tamil nadu, India - Full Time
Skills Needed
Generative Ai, Applied Machine Learning, Python, Ml Libraries, Technical Leadership, Stakeholder Engagement, Model Development, Innovation Leadership, Feature Engineering, Hypothesis Driven Problem Solving, Deployment Pipelines, Scalability, Collaboration, Communication, Quality Assurance, Mentoring
Specialization
Candidates should have over 15 years of experience in Generative AI and applied machine learning, with strong coding abilities and a solid foundation in ML principles. They must possess visionary leadership skills and the ability to communicate complex concepts effectively.
Experience Required
Minimum 10 year(s)
Business Development Leader - Uganda at Visa
Kampala, Arua, Uganda - Full Time
Skills Needed
Business Development, Relationship Management, Strategic Planning, Sales Leadership, Risk Management, Compliance, Marketing, Innovation, Financial Acumen, Cross Functional Collaboration, Communication, Project Management, Client Solutions, Entrepreneurial Mindset, Cultural Navigation, Analytical Skills
Specialization
Candidates should have extensive experience in the payments and digital commerce industry, with strong commercial acumen and sales leadership skills. A proven ability to manage P/L and drive innovation in a fast-paced environment is essential.
Experience Required
Minimum 10 year(s)
Housekeeping Coordinator at Accor
Miami Beach, Florida, United States - Full Time
Skills Needed
Housekeeping, Communication, Organization, Attention To Detail, Multitasking, Teamwork, Pms Systems, Guest Service, Scheduling, Reporting, Inventory Management, Training, Problem Solving, Time Management, Administrative Skills, Service Standards
Specialization
Candidates should have 3-5 years of experience in housekeeping or hotel operations, along with strong administrative and communication skills. Proficiency in hotel PMS/Housekeeping systems and the ability to multitask in a fast-paced environment are essential.
Experience Required
Minimum 2 year(s)
Développeur .Net / Devsecops at Tilencia
Paris, Ile-de-France, France - Full Time
Skills Needed
Devops, Cybersecurity, Ci/Cd, Cloud Native, .Net Core, Apis, Infrastructure As Code, Automation, Powershell, Bash, Azure Cli, Python, Agile, User Centric, Documentation, Collaboration
Specialization
Candidates should have experience in designing and developing CI/CD solutions, as well as knowledge of cybersecurity and cloud architectures. Autonomy, rigor, and strong writing skills are also essential.
Experience Required
Minimum 2 year(s)
Data Analytics Engineer at easyJet
, , - Full Time
Skills Needed
Python, Sql, Troubleshooting, Tableau, Thoughtspot, Aws, Gcp, Databricks, Redshift, Bigquery, Snowflake, Apis, Databases, Collaboration, Innovation, Results Focused
Specialization
Candidates should have strong Python and SQL skills, along with experience in troubleshooting data pipeline issues. Familiarity with analytics platforms and cloud services is also required.
Experience Required
Minimum 2 year(s)
Data Analytics Engineer at easyJet
, , - Full Time
Skills Needed
Python, Sql, Troubleshooting, Tableau, Thoughtspot, Aws, Gcp, Databricks, Redshift, Bigquery, Snowflake, Apis, Databases, Collaboration, Innovation, Results Orientation
Specialization
Candidates should have strong Python and SQL skills, along with experience in troubleshooting data pipeline issues. Familiarity with analytics platforms and cloud services is also required.
Experience Required
Minimum 2 year(s)
Reservations Manager - Raffles the Red Sea at Accor
Umluj, Tabuk, Saudi Arabia - Full Time
Skills Needed
Creativity, Stress Management, Self Development, Listening Skills, Oral Skills, Delegation, Organization, Deadline Management, Leadership, Training, Instruction, Reservation Management, Customer Service, Problem Solving, Communication, Report Generation
Specialization
Candidates should have a degree or diploma in Training and Development or Hotel Management, along with a minimum of 3 years of experience in a hotel or resort setting. Experience in luxury hotels and understanding of local culture is preferred.
Experience Required
Minimum 2 year(s)
Cafe Barista at Accor
Miami Beach, Florida, United States - Full Time
Skills Needed
Coffee Preparation, Guest Service, Team Collaboration, Inventory Management, Health And Safety Standards, Communication Skills, Multitasking, Espresso Machine Operation, Latte Art, Food Hygiene, Attention To Detail, Positive Attitude, Customer Service, Continuous Learning, Problem Solving, Organizational Skills
Specialization
Candidates should have a high school diploma and proven experience in coffee preparation. Strong communication skills and the ability to multitask in a fast-paced environment are essential.
Equipier Commercial CDD F/H at METRO/MAKRO
Vannes, Brittany, France - Full Time
Skills Needed
Teamwork, Customer Relationship, Operational Skills, Product Knowledge, Sales Skills, Attention To Detail
Specialization
The ideal candidate should demonstrate rigor and a desire to work in a team environment. Strong interpersonal skills and a proactive attitude are essential.
Senior Scientist at Eurofins
Portage, Michigan, United States - Full Time
Skills Needed
Analytical Procedures, Attention To Detail, Communication, Data Processing, Gmp, Glp, Instrumentation, Laboratory Equipment Maintenance, Reagent Preparation, Sample Preparation, Teamwork, Validation Projects
Specialization
Candidates should have a Bachelor's degree in a related field and at least three years of related experience. Excellent communication skills and the ability to work independently or as part of a team are essential.
Experience Required
Minimum 2 year(s)
Consultant(e) Transport, Manufacturing & Retail - Bureau de Lyon at Sia Partners - United Kingdom
Lyon, Auvergne-Rhône-Alpes, France - Full Time
Skills Needed
Teamwork, Analytical Skills, Project Management, Change Management, Marketing, Distribution Strategy, Supply Chain Strategy, Data Science, Regulatory Compliance, Risk Management, Process Redesign, Client Engagement, Training Development, Business Development, Innovation, Entrepreneurship
Specialization
Candidates should have a degree from a prestigious engineering or business school and ideally possess experience in consulting or relevant sectors. Strong teamwork, analytical skills, and proficiency in French and English are essential.
Experience Required
Minimum 2 year(s)
Microbiolgy Analyst at COMBE INCORPORATED.
Rantoul, Illinois, United States - Full Time
Skills Needed
Basic Math Skills, Good Organizational Skills, Computer Data Entry, Ability To Follow Written Directions
Specialization
A high school diploma or equivalent is required, with some microbiology experience preferred. The position also requires good vision, legible handwriting, and the ability to perform physical tasks.
Ingénieur thermicien H/F at Socotec
Saint-Ouen-sur-Seine, Ile-de-France, France - Full Time
Skills Needed
Thermal Engineering, Energy Audits, Thermal Simulation, Technical Expertise, Building Regulations, Thermography, Cvc Knowledge
Specialization
Candidates should have a degree in engineering or equivalent and demonstrate analytical skills, curiosity, autonomy, and writing abilities. Required knowledge includes building thermal performance and proficiency in thermal and energy study software.
Technicien en mesure de la performance des bâtiments H/F at Socotec
Strasbourg, Grand Est, France - Full Time
Skills Needed
Acoustic Measurement, Thermal Performance Measurement, Air Tightness Testing, Regulatory Compliance, Client Advisory, Project Assistance, Technical Training, Organizational Skills, Customer Service, Commercial Awareness
Specialization
Candidates should have a technical background in building with a Bac +2 / +4 education and ideally three years of experience in the field. Qualifications in air tightness measurement and energy performance certification are preferred.
Experience Required
Minimum 2 year(s)
Delivery Driver - Hiring All Shifts - 1721 Spring Green at Domino's Pizza LLC
Katy, Texas, United States - Full Time
Skills Needed
Customer Service, Food Safety, Store Operations, Technology Operation, Troubleshooting
Specialization
Candidates must have a valid driver's license and access to an insured vehicle for deliveries. They should also be at least 18 years old with one year of driving history.